MARY M PECKMAN TR FBO CHEN MEM HOSPITAL: Form 990PF, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MARY M PECKMAN TR FBO CHEN MEM HOSPITAL (EIN 15-6017708)
- Tax period
- 2015-04-01 to 2016-03-31
- Filed
- 2016-07-27
- IRS object ID
- 201642099349100119
- Schema version
- 2015v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990-PF
- Accounting Fees Schedule
- Investments Corp Bonds Schedule
- Investments Govt Obligations Sch
- Investments Other Schedule2
- Other Decreases Schedule
- Other Expenses Schedule
- Other Increases Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-07-27T15:00:16-05:00 | ReturnTs |
| Tax Period End | 2016-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 WOOD AVE SOUTH | AddressLine1Txt |
| City | ISELIN | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 08830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2015-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 156017708 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY PECKHAM FBO CHENANGO MEM HOSPITAL 003154 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PECK | BusinessNameControlTxt |
| Phone | 6073376191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O NBT BANK NA 52 S BROAD ST | AddressLine1Txt |
| City | NORWICH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY J HANDY | PersonNm |
| Person Title | SENIOR VP | PersonTitleTxt |
| Phone | 6073376191 | PhoneNum |
| Signature | 2016-07-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DIEGO RESTREPO | PreparerPersonNm |
| PTIN | P00670890 | PTIN |
| Phone | 7327679100 | PhoneNum |
| Preparation | 2016-07-27 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $3,323,846 | FMVAssetsEOYAmt |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Dividends Rev And Expnss | $91,770 | DividendsRevAndExpnssAmt |
| Dividends Net Invst Incm | $91,770 | DividendsNetInvstIncmAmt |
| Net Gain Sale Ast Rev And Expnss | $8,044 | NetGainSaleAstRevAndExpnssAmt |
| Gross Sales Price | $913,007 | GrossSalesPriceAmt |
| Cap Gain Net Incm Net Invst Incm | $8,044 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Total Rev And Expnss | $99,814 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $99,814 | TotalNetInvstIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $30,862 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $27,776 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $3,086 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $0 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $0 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Net Invst Incm | $0 | PensionEmplBnftNetInvstIncmAmt |
| Pension Empl Bnft Adj Net Incm | $0 | PensionEmplBnftAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $0 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $750 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $0 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $750 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Dsbrs Chrtbl | $0 | OtherProfFeesDsbrsChrtblAmt |
| Interest Dsbrs Chrtbl | $0 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $2,956 | TaxesRevAndExpnssAmt |
| Taxes Net Invst Incm | $2,157 | TaxesNetInvstIncmAmt |
| Taxes Dsbrs Chrtbl | $0 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $0 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Net Invst Incm | $0 | DeprecAndDpltnNetInvstIncmAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $0 | TravConfMeetingAdjNetIncmAmt |
| Printing And Pub Rev And Expnss | $3 | PrintingAndPubRevAndExpnssAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Printing And Pub Dsbrs Chrtbl | $3 | PrintingAndPubDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $250 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Dsbrs Chrtbl | $250 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $34,821 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $29,933 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $0 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $4,089 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $177,547 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $177,547 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $212,368 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $29,933 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $0 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $181,636 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$112,554 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $69,881 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $0 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash EOY | $749 | CashEOYAmt |
| Cash EOYFMV | $749 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $101,167 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $67,503 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $67,503 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl EOY | $0 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $0 | AcctRcvblEOYFMVAmt |
| Other Rcvbl Allwnc Dbtfl Acct | $0 | OtherRcvblAllwncDbtflAcctAmt |
| US Government Obligations BOY | $196,057 | USGovernmentObligationsBOYAmt |
| US Government Obligations EOY | $48,467 | USGovernmentObligationsEOYAmt |
| US Govt Obligations EOYFMV | $50,977 | USGovtObligationsEOYFMVAmt |
| Corporate Bonds BOY | $251,273 | CorporateBondsBOYAmt |
| Corporate Bonds EOY | $200,948 | CorporateBondsEOYAmt |
| Corporate Bonds EOYFMV | $214,282 | CorporateBondsEOYFMVAmt |
| Other Investments BOY | $2,961,883 | OtherInvestmentsBOYAmt |
| Other Investments EOY | $3,079,951 | OtherInvestmentsEOYAmt |
| Other Investments EOYFMV | $2,990,335 | OtherInvestmentsEOYFMVAmt |
| Total Assets BOY | $3,510,380 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,397,618 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $3,323,846 | TotalAssetsEOYFMVAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $3,510,380 | CapitalStockBOYAmt |
| Capital Stock EOY | $3,397,618 | CapitalStockEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $3,510,380 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,397,618 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $3,510,380 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $3,397,618 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $3,510,380 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$112,554 | ExcessRevenueOverExpensesAmt |
| Other Increases | $1,033 | OtherIncreasesAmt |
| Subtotal | $3,398,859 | SubtotalAmt |
| Other Decreases | $1,241 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $3,397,618 | TotNetAstOrFundBalancesEOYAmt |
Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail
Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (29 entries)
| PropertyPropertyDesc | SoldSoldDt | Gross Sales PriceGrossSalesPriceAmt | Cost Or Other BasisCostOrOtherBasisAmt | Gain Or LossGainOrLossAmt | Gains Minus Excess Or LossesGainsMinusExcessOrLossesAmt | AcquiredAcquiredDt | How AcquiredHowAcquiredCd |
|---|---|---|---|---|---|---|---|
| 75000. FNMA 5.000% 4/15/15 | 2015-04-15 | $75,000 | $74,890 | $110 | $110 | ||
| 722.937 AMERICAN BEACON L/C VALU-IS | 2015-04-27 | $21,746 | $20,163 | $1,583 | $1,583 | 2014-01-30 | |
| 292.503 DIAMOND HILL SMALL/MID CAP-I | 2015-04-27 | $5,736 | $4,964 | $772 | $772 | 2013-07-19 | |
| 468.381 LAZARD GL LIST INFRASTRUCTURE-INST | 2015-04-27 | $7,157 | $6,440 | $717 | $717 | 2014-04-11 | |
| 625.927 PRIMECAP ODYSSEY GROWTH | 2015-04-27 | $16,969 | $14,941 | $2,028 | $2,028 | 2014-01-30 | |
| 151.999 VANGUARD #94 INSTITUTIONAL INDEX | 2015-04-27 | $29,298 | $25,001 | $4,297 | $4,297 | 2014-01-30 | |
| 10537.606 LOOMIS SAYLES BOND FUND-INS | 2015-06-01 | $153,638 | $159,454 | -$5,816 | -$5,816 | ||
| 164.42677 AMERICAN BEACON L/C VALU-IS | 2015-09-09 | $4,441 | $4,586 | -$145 | -$145 | 2014-01-30 | |
| 79.44623 AMERICAN BEACON L/C VALU-IS | 2015-09-09 | $2,146 | $2,216 | -$70 | -$70 | 2014-01-30 | |
| 9150.736 BLACKROCK HIGH YIELD BD-INST | 2015-09-09 | $70,461 | $75,402 | -$4,941 | -$4,941 | 2014-01-30 | |
| 97.538 DFA U.S. MICRO CAP PORTFOLIO | 2015-09-09 | $1,808 | $1,894 | -$86 | -$86 | 2014-01-30 | |
| 3819.885 DFA INTERNATIONAL SMALL CO | 2015-09-09 | $65,969 | $72,655 | -$6,686 | -$6,686 | ||
| 25.996 DFA US S/C VALUE PORTFOLIO | 2015-09-09 | $844 | $883 | -$39 | -$39 | 2014-01-30 | |
| 1876.699 PRIMECAP ODYSSEY GROWTH | 2015-09-09 | $49,094 | $44,797 | $4,297 | $4,297 | 2014-01-30 | |
| 11545.028 TEMPLETON GLOBAL BOND FUND-AD | 2015-09-09 | $132,652 | $151,789 | -$19,137 | -$19,137 | ||
| 468.764 VANGUARD S/T INFL PROT-ADM | 2015-09-09 | $11,353 | $11,611 | -$258 | -$258 | 2014-01-30 | |
| 76.945 VANGUARD #94 INSTITUTIONAL INDEX | 2015-09-09 | $13,709 | $12,656 | $1,053 | $1,053 | 2014-01-30 | |
| 50000. FHLB 4.750% 9/11/15 | 2015-09-11 | $50,000 | $50,000 | 2007-07-16 | |||
| 256.236 AMERICAN BEACON L/C VALU-IS | 2015-12-01 | $7,369 | $7,146 | $223 | $223 | 2014-01-30 | |
| 292.401 DODGE & COX INTL STOCK FUND | 2015-12-01 | $11,547 | $9,287 | $2,260 | $2,260 | 2011-10-26 | |
| 428.725 OPPENHEIMER INTL GROWTH FD-Y | 2015-12-01 | $16,000 | $15,550 | $450 | $450 | 2014-01-30 | |
| 42.352 VANGUARD #94 INSTITUTIONAL INDEX | 2015-12-01 | $8,166 | $6,966 | $1,200 | $1,200 | 2014-01-30 | |
| 802.692 DFA EMERGING MKTS PORTFOLIO | 2015-12-21 | $16,600 | $19,441 | -$2,841 | -$2,841 | 2014-01-30 | |
| 188.157 DODGE & COX INTL STOCK FUND | 2015-12-21 | $6,792 | $5,976 | $816 | $816 | 2011-10-26 | |
| 1306.665 LAZARD EMERGING MKTS PORT-IN | 2015-12-21 | $17,692 | $24,461 | -$6,769 | -$6,769 | 2011-10-26 | |
| 307.911 OPPENHEIMER INTL GROWTH FD-Y | 2015-12-21 | $10,940 | $11,168 | -$228 | -$228 | 2014-01-30 | |
| 50000. GOLDMAN SACHS GROUP 3.625% 2/07/16 | 2016-02-07 | $50,000 | $50,325 | -$325 | -$325 | 2012-02-14 | |
| 25000. FNMA 5.000% 3/15/16 | 2016-03-15 | $25,000 | $24,887 | $113 | $113 | 2006-08-31 | |
| CAPITAL GAIN DIVIDENDS | $35,321 | P |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Capital Gain Net Income | $8,044 | CapitalGainNetIncomeAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | false | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $168,661 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $3,627,624 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.046494 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $164,822 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $3,536,834 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.046602 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $161,012 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $3,291,618 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.048916 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $159,469 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $3,238,521 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.049241 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $190,353 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $3,210,499 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.059291 | DistributionYr5Rt |
| Total Distribution | 0.250544 | TotalDistributionRt |
| Average Distribution | 0.050109 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $3,231,894 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $161,947 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $699 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $162,646 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $181,636 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Domestic Org Meeting Sect4940e | Yes (X) | DomesticOrgMeetingSect4940eInd |
| Investment Income Excise Tax | $699 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $699 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $699 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $3,836 | EstimatedPlusOvpmtIncmTxAmt |
| Applied To Es Tax | $0 | AppliedToEsTaxAmt |
| Total Payments And Credits | $3,836 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $0 | EsPenaltyAmt |
| Overpayment | $3,137 | OverpaymentAmt |
| Applied To ES Tax | $3,137 | AppliedToESTaxAmt |
| Refund | $0 | RefundAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | NY | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NBT BANK NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6073376193 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 52 S BROAD STREET | AddressLine1Txt |
| City | NORWICH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Undistr Incm Sect4942a2 Not App | false | UndistrIncmSect4942a2NotAppInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NBT BANK NA | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 52 SOUTH BROAD STREET | AddressLine1Txt |
| City | NORWICH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Title | TRUSTEE | TitleTxt |
| Average Hrs Per Wk Devoted To Pos | 1 | AverageHrsPerWkDevotedToPosRt |
| Compensation | $30,862 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Summary Of Direct Chrtbl Acty | SummaryOfDirectChrtblActyGrp | |
| Sum Of Program Related Invst | SumOfProgramRelatedInvstGrp |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $3,199,562 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $81,549 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,281,111 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $3,281,111 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $49,217 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,231,894 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $161,595 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $161,595 | MinimumInvestmentReturnAmt |
| Tax Based On Investment Income | $699 | TaxBasedOnInvestmentIncomeAmt |
| Total Tax | $699 | TotalTaxAmt |
| Distributable Before Adj | $160,896 | DistributableBeforeAdjAmt |
| Recoveries Qualfied Distri | $0 | RecoveriesQualfiedDistriAmt |
| Distributable Before Ded | $160,896 | DistributableBeforeDedAmt |
| Deduction From Distributable | $0 | DeductionFromDistributableAmt |
| Distributable As Adjusted | $160,896 | DistributableAsAdjustedAmt |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $181,636 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $181,636 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $699 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $180,937 | AdjustedQualifyingDistriAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $160,896 | DistributableAsAdjustedAmt |
| Undistributed Income PY | $6,050 | UndistributedIncomePYAmt |
| Total For Prior Years | $0 | TotalForPriorYearsAmt |
| Excess Distribution Cyov Yr5 | $0 | ExcessDistributionCyovYr5Amt |
| Excess Distribution Cyov Yr4 | $0 | ExcessDistributionCyovYr4Amt |
| Excess Distribution Cyov Yr3 | $0 | ExcessDistributionCyovYr3Amt |
| Excess Distribution Cyov Yr2 | $0 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $0 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $181,636 | QualifyingDistributionsAmt |
| Applied To Year1 | $6,050 | AppliedToYear1Amt |
| Applied To Prior Years | $0 | AppliedToPriorYearsAmt |
| Treated As Distri From Corpus | $0 | TreatedAsDistriFromCorpusAmt |
| Applied To Current Year | $160,896 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $14,690 | RemainingDistriFromCorpusAmt |
| Excess Distri Cyov App CY Corpus | $0 | ExcessDistriCyovAppCYCorpusAmt |
| Excess Distribution Cyov App CY | $0 | ExcessDistributionCyovAppCYAmt |
| Total Corpus | $14,690 | TotalCorpusAmt |
| Prior Year Undistributed Incm | $0 | PriorYearUndistributedIncmAmt |
| Prior Year Deficiency Or Tax | $0 | PriorYearDeficiencyOrTaxAmt |
| Taxable1 | $0 | Taxable1Amt |
| Taxable2 | $0 | Taxable2Amt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Corpus Distri170b1 E Or4942g3 | $0 | CorpusDistri170b1EOr4942g3Amt |
| Excess Distri Cyov From Yr5 | $0 | ExcessDistriCyovFromYr5Amt |
| Excess Distri Cyov To Next Yr | $14,690 | ExcessDistriCyovToNextYrAmt |
| Excess From Year4 | $0 | ExcessFromYear4Amt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $0 | ExcessFromYear2Amt |
| Excess From Year1 | $0 | ExcessFromYear1Amt |
| Excess From Current Year | $14,690 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chenango Memorial | BusinessNameLine1Txt |
| Business Name Line2 | Hospital | BusinessNameLine2Txt |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 179 NORTH BROAD STREET | AddressLine1Txt |
| City | Norwich | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13815 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Relationship | N/A | RecipientRelationshipTxt |
| Recipient Foundation Status | PC | RecipientFoundationStatusTxt |
| Grant Or Contribution Purpose | GENERAL PURPOSES - MEMORY | GrantOrContributionPurposeTxt |
| Amt | $177,547 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $177,547 | TotalGrantOrContriPdDurYrAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp | |
| Int On Sav And Temp Cash Invst | IntOnSavAndTempCashInvstGrp |
Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $91,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Incm Part VII | OtherInvestmentIncmPartVIIGrp |
Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 18 | ExclusionCd |
| Exclusion | $8,044 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $99,814 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $99,814 | TotalIncomeProducingActyAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Rln Of Acty To Accom Of Exmpt Prps | RlnOfActyToAccomOfExmptPrpsGrp |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | TAX PREPARATION FEE | CategoryTxt |
| Amt | $750 | Amt |
| Disbursements Charitable Prps | $750 | DisbursementsCharitablePrpsAmt |
Investments Corp Bonds Schedule InvestmentsCorpBondsSchedule
Investments Corporate Bonds InvestmentsCorporateBondsGrp (4 entries)
| BondBondNm | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|
| BANK OF AMERICA 6.4% 8-15-19 | $50,000 | $55,634 |
| GOLDMAN SACHS 3.625% 2/7/16 | ||
| COLGATE- PALM 2.45% 11/15/2021 | $51,439 | $51,892 |
| PEPSICO INC 3.0% 8/25/21 | $99,509 | $106,756 |
Investments Govt Obligations Sch InvestmentsGovtObligationsSch
| Field | Value | IRS element (for citing) |
|---|---|---|
| US Govt Obligations Book Vl EOY | $48,467 | USGovtObligationsBookVlEOYAmt |
| US Govt Obligations EOYFMV | $50,977 | USGovtObligationsEOYFMVAmt |
Investments Other Schedule2 InvestmentsOtherSchedule2
Investments Other InvestmentsOtherGrp (20 entries)
| Category Or ItemCategoryOrItemTxt | Listed At Cost Or FMVListedAtCostOrFMVCd | Book ValueBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| DFA INTERNATIONAL SMALL CO | AT COST | $77,405 | $68,100 |
| OPPENHEIMER INTL GROWTH FD-Y | AT COST | $236,763 | $237,954 |
| CREDIT SUISSE COMM RET | AT COST | $90,708 | $59,550 |
| DFA US S/C VALUE PORT | AT COST | $36,313 | $33,476 |
| DFA GLOBAL REAL ESTATE SEC | AT COST | $94,560 | $115,689 |
| AMERICAN BEACON L/C VALUE | AT COST | $271,207 | $239,339 |
| DIAMOND HILL SMALL MIDCAP-1 | AT COST | $126,279 | $138,083 |
| DFA EMERGING MKTS PORT | AT COST | $97,967 | $89,618 |
| DODGE & COX INCOME FD | AT COST | $342,078 | $339,720 |
| PRIMECAP ODYSSEY GROWTH | AT COST | $155,132 | $161,347 |
| VANGUARD INSTITUTIONAL INDEX | AT COST | $213,748 | $241,670 |
| LAZARD EMERGING MKTS | AT COST | $108,578 | $88,020 |
| DODGE & COX INTL STOCK FD | AT COST | $246,244 | $237,726 |
| DFA U S MICRO CAP PORT | AT COST | $35,763 | $32,553 |
| TEMPLETON GLOBAL BD FD | AT COST | $79,065 | $70,047 |
| LOOMIS SAYLES BD FD | AT COST | $158,079 | $138,041 |
| BLACKROCK HIGH YIELD BD PORT | AT COST | $113,324 | $97,925 |
| VANGUARD SHORT-TERM INFLAT | AT COST | $140,216 | $139,269 |
| VANGUARD TOTAL BD MKT INDEX FD | AT COST | $353,750 | $357,366 |
| LAZARD GI LIST INFRASTRUCTURE | AT COST | $102,772 | $104,842 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INCOME PD IN 2016 TAXED IN 2015 | $1,240 |
| ROUNDING | $1 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NYS EPTL FILING FEE | Desc |
| Revenue And Expenses Per Books | $250 | RevenueAndExpensesPerBooksAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Disbursements Charitable Prps | $250 | DisbursementsCharitablePrpsAmt |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCOME PD IN 2015 TAXED IN 2014 | Desc |
| Amt | $1,033 | Amt |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (3 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| ESTIMATED EXCISE TAX | $799 | $0 | $0 |
| FOREIGN TAXES ON QUALIFIED | $1,586 | $1,586 | $0 |
| FOREIGN TAXES ON NONQUALIFED | $571 | $571 | $0 |